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General NPI Number Information
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NPI Number | 1245696772
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Entity Type | Individual
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Provider Name | GUISEON KIM NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 4400 PEACHTREE RD NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-2729
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Country | US
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Telephone | 404-814-9199
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 PEACHTREE RD NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-2729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP08551
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NP002954
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 905033
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License Number State | MS
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